By Anne C. Woodlen

It is Sunday here at Happy Valley and Frankie the Rug is visiting his mother, Rose of Sharing. They are arguing in the waiting area, a small space between the front lobby and the dining room. This space is perfectly square, has loveseats on three sides, and a sign briskly informing the residents that they may only sit there if they are waiting for transportation. The residents ignore the sign; it is their home.

Rose of Sharing is in her usual place with her wheelchair between the door to the dining room and one of the loveseats. Frankie the Rug, who is almost as wide as he is tall, is sitting on one of the loveseats. His hands are folded across his chest and he is arguing with his mother, who wants to go to Daybreak. Daybreak is the name of the elder daycare program in the building at the top of the hill. Frankie is sputtering about the cost of the program and the unavailability of wheelchair transportation.

I, being infinitely helpful, ask Rose if she has Medicaid and Medicare. When she says yes, I tell Frankie that they will pay for the program and that Loretto has a wheelchair-accessible bus that comes every day to pick people up and take them to Daybreak. Frankie changes his argument to the fact that his mother can’t toilet herself. Other women sitting in the waiting area—this is a community problem, not a confidential one—assure Frankie that there are nurses at Daybreak and they take people to the bathroom. Yes, even people in wheelchairs. Definitely, people in wheelchairs.

Frankie continues to argue that his mother can’t go to Daybreak. Why would she want to, anyway?

She would want to because she is a mentally acute 83-year-old who knows who she is, where she’s at, and that she’s bored sitting in the waiting area all day. Rose is a social person and all her friends go to Daybreak. Frankie argues that all they do there is play Bingo, not understanding that just playing Bingo somewhere else can be very uplifting. He argues that because of her health, she can’t go. This leads to a discussion of the Lifeline alert system, and an explanation of why some of the residents are wearing wristwatches on both arms. Only one is a wristwatch; the other is a wrist alarm. They press it and it triggers an alarm in some office that results in a medical aide being sent to them immediately. This is for patients who are too fragile to even crawl to the bathroom and pull the emergency buzzer.

I set out to learn just how fragile Rose is. She says she has a pacemaker. So does my mom, I say, adding that my mom can still drive fifty miles to her granddaughter’s house. Rule out pacemaker as reason for Rose to be disqualified from Daybreak. How often has she had to use the wrist alarm, and over what period, I ask? Rose and Frankie discuss whether it’s one, two or three times, and are completely unresponsive to the question of whether these alarms have occurred over a period of three weeks or three years.

Frankie insists that he has asked Natalie the Administrator (Natalie is not the administrator; Howard is) three times, and three times she has told him his mother can’t go to Daybreak. Now he walks away to ask “the nurse” about it. The nurse is an aide, and aides don’t know diddly about how the bureaucratic system works. If a doctor orders day care, then Rose goes to daycare, never mind Natalie. While Frankie is away, I describe to Rose my experience and training as an advocate, and tell her that the important thing is to ask questions and get information. She asks for my help, and I tell her I’d be honored to serve her.

As Frankie returns, I observe that there is a curl to his salt-and-pepper gray hair so, to lighten a tense moment, I ask Rose of Sharing where he got such lovely hair. To my mortal embarrassment, Frankie proceeds to tell me where he bought it. Then he reports that “the nurse” says Rose is in the “L-program” and therefore can’t go to Daybreak. L-program, my ass. Rose has Medicaid and is in Assisted Living, not Skilled Nursing: Rose is going to some day program, somewhere. Maybe not Daybreak, but the program I came from, which has patients with Multiple Sclerosis, as well as a lot of cardiac patients, might be a possibility.

I have not been able to figure out why Frankie is so adamant that his mother cannot go to Daybreak but now the pattern is beginning to emerge, so I take Frankie outside and have a listen with him.

He has lived with his mother all his life. After his parents sold the farm, they moved to a senior trailer park in Florida. His father died ten years ago. When Frankie went to Florida to visit his mother four years ago, she looked worse than she ever had in her life. The freezer and refrigerator were full, but she wasn’t eating. She was sitting by the pool with her friends, smoking two packs a day and drinking a lot. He brought her home, cooked for her and got her to stop drinking.

His sister, who is no help at all, proposed that she build a mother-in-law apartment on the back of her house. Frankie said, “What good’s that going to do? You and your husband are away from seven in the morning till ten at night. She’d be worse off there than she is now.”

Frankie and Rose had a joint bank account; Frankie worked every day to fill it. When his health started to break down, he cut back to only working five days a week. The money from the farm was going to pay for doctors, nurses, aides. The lawyers gave them advice, but it was no good. His mother told him to take $8000 and put it in a separate account. Frankie said it wouldn’t do any good; Medicaid would get it in the end. They take everything. They take all your money. There’s nothing left.

He knows his mother wants to go to Daybreak, but there’s no money. It costs $94 a day, and there’s just no money. They keep telling him his mother can’t go, but he doesn’t know why. His sister should be there; she’s the one who understands this stuff, but she doesn’t come.

Frankie dreads what will happen when he turns sixty-five.

I tell Frankie that he’s a good son; that he’s practically worked himself to death to take care of his mother; that nobody should have to go up against the system alone; that it’s not his fault that he doesn’t understand Natalie; the system is too complex, you can’t work it alone. I tell him that I understand that he has no money; that elder care in our society is just awful, and it’s not his fault; that he’s done a wonderful thing in getting his mother here, where she’s safe and healthy. I tell him I know how much his mother means to him, and how great he’s been, and how tough the situation is.

I tell him I will talk to Natalie tomorrow, and see if I can help.